Objective To study far femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint transplantation and the use of GSH nail Methods Eleven cases with far femoral malignant bone tumor were administered tumor resection,transplanted with allogeneic heterotoeic bone half-joint,and fixed with GSH nail Results Nine out of the 11 cases were followed up.None of them had infection,rejection or heterotopic bone fracture.All of them can move with walking after 6 months.The effects of surgery was rated as excellent for 3 cases,fine for 4 cases andbad for 2 cases according to Mankin's rating criteria.Conclusion Salvage limb treatment for bone tumor can improve patients' quality of life.Allogeneic heterotopic bone,with rich source and acceptable joint surface,is a good graft for the treatment of bone defect after bone tumor resection.

Objective To evaluate the clinical application of open reduction and internal fixation and bone grafting on treatment of pilon fractures of tibia.Methods Forty cases with Pilon fractures of Ⅱ,Ⅲ tibia who underwent open reduction and intemalfixation and bone grafting treatment were selected as our subjects.Those 40 cases were performed follow-up for 8.0-60.0 months,and average was 31.5 months.The ankle joint symptoms and functional Mazur scoring system were used to evaluate the function of ankle joint.Results Of the 40 patients,15 cases were with excellent ankle function,and 19 cases were good,4 cases were poor and 2 cases were worse.The excellent and good rate was 85％ (34/40).Conclusion Open reduction and internal fixation and bone grafting is proved as the effective treatment on Ⅱ,Ⅲ tibia pilon fractures.

Depression is a common mental disorder with high incidence rate and low remission rate.The prediction of therapeutic effect in depression is limited to clinical features and neuroimaging.Reviewed the Results of magnetic resonance imaging for predicting the treatment response in depression and explored the Objective image markers for predicting the therapeutic effect in depression.It showed that the studies mainly focused on emotion regulation neural circuitry and few on reward neural circuitry.Prefrontal cortex,cingulate cortex,amygdala and hippocampus play important roles on predicting therapeutic effect.The study of magnetic resonance imaging for predicting therapeutic effect in depression is a feasible research field.More researches of finding the role of reward neural circuits in predicting the effect of antidepressants are needed.The brain structure and function of the neural circuits involved in depression and predicting the effect of anti-depression need to be studied by multimodal MRI method.

Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3％ (3 cases),contralateral nephrectomy in 42.8％ (9 cases),and functional solitry kidneys in 42.8％ (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7％),2 (9.5％),1 (4.8％) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7％ (18/21).The final stone free rate increased to 95.2％ (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4％ (n=15),23.8％ (n=5),and 4.8％ (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.

Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).

This study is to investigate the effect of Euphorbia humifusa effective fraction (EHEF) on the CYP51 enzyme activity, the lanosterol content and the MEP, SUB gene expression of Trichophyton rubrum. Trichophyton rubrum was treated by EHEF for 7 days at 26 degrees C. The activity of CYP51 enzyme of Trichophyton rubrum in the cell membrane was determined by using ELISA kit, and the lanosterol content was investigated by using high performance liquid chromatography (HPLC), and the MEP, SUB gene expression of Trichophyton rubrum was detected with the reverse transcription polymerase chain reaction (RT-PCR) method. Results showed that EHEF can decrease the membrane CYP51 enzyme activity, and it also can accumulate the fungal lanosterol in a dose-dependent manner, and it also can decrease the gene expression of MEP and SUB. The antifungal mechanism of EHEF may be related to the inhibition on CYP51 enzyme activity, and to the effects on fungal cell membrane ergosterol biosynthesis. It may also play an antifungal effect by inhibiting the MEP, SUB gene expression of fungal proteases.

Objective To investigete the effect of low-concentration ozone (O3) on voltage-gated calcium channels in fetal rat spinal cord neurons in vitro. Methods The spinal cord neurons were cultured in vitro and identified by immunohistochemistry staining. Then the cells were seeded into the culture dish and randomly divided into 3 groups: control group (group C, n = 5), O3 15 μg/ml (group O3-15, n = 4) and O3 20 μg/ml group (group O3-20, n = 8). The cells were exposed to O3 15 and 20 μg/ml in group O3-15 and O3-20 respectively, while the cells were exposed to air in group C. After 20 min incubation, the electrophysiological activity of calcium channels in neurons was recorded using whole-cell patch-clamp technique. Results Peak calcium current density was significantly increased in group O3-15 and O3-20 compared with group C ( P ＜ 0.05). Half-activation voltage was significantly lower in group O3-15 and O3-20 than in group C ( P ＜ 0.05). Peak calcium current density was significantly higher in group O3 -20 than in group O3-15 ( P ＜ 0.05) . There was no significant difference in half-inactivation voltage among the three groups ( P ＞ 0.05). Conclusion Low concentration of O3 can make the activation of the calcium ion channel easy in fetal rat spinal cord neurons in vitro.

Objective To explore the role of Janus kinase/signal transduction and transcriptional activation (JAK/STAT) pathway in rat liver damaged by excessive fluorine.Methods Thirty-six healthy Sprague-Dawley (SD) rats were randomized by weight and divided into three groups (6 males and 6 females per group):a control group (drunk water containing NaF ＜1 mg/L) and two fluorosis groups (drunk water containing NaF of 5 mg/L and 50 mg/ L).After 6 months of experiment treatment,the fluorine contents of urine and bone were detected by fluorine-ion electrode method.The rats liver function was determined by automatic blood chemical analyzer.The protein expression of Janus kinase (JAK1),signal transducer and activator of transcription (STAT3),B-cell lymphoma/ leukemia-2 (Bcl-2) and Bcl-associated x protein (Bax) were detected by immunohistochemistry (IHC) and protein imprinting (Western blotting).The activity of superoxide dismutase (SOD),glutathione peroxidase (GSH-PX) and the content of lipid peroxide (LPO) in liver tissue were determined with oxidative stress kit.Results The fluorine contents in the urine and bone in low-[(1.90 ± 0.12)mg/L,(210.37 ± 15.81)mg/kg] and high-dose [(2.20 ± 0.17)mg/L,(222.84 ± 10.21)mg/kg] fluoride groups were higher than those of control group [(1.74 ± 0.11)mg/L;(165.48 ± 10.37) mg/kg,F =33.840,69.149,P ＜0.05];the activity of serum alanine aminotransferase (ALT) and aspartate transaminase (AST) in high-dose fluorosis group [(69.83 ± 11.18),(167.56 ± 50.85) U/L] was higher than those of control group [(42.67 ± 7.07),(126.31 ± 16.76)U/L,F =32.135,4.984,all P ＜0.05];the protein expression of JAK1,STAT3 and Bax (1.56 ± 0.31,1.49 ± 0.49,1.41 ± 0.55) in high-dose fluorosis group were significantly higher than those of control group(1.01 ± 0.11,1.04 ± 0.15,0.87 ± 0.21,F=10.923,5.361,5.009,all P＜0.05),and Bcl-2 (0.61 ± 0.15) was significantly lower in high-dose fluorosis group than control group (1.04 ± 0.17,F =16.017,P ＜0.05);the activities of SOD and GSH-PX [(7.22 ± 0.88),(7.23 ± 2.47)U/mg prot] were significantly lower in high-dose fluorosis group than control group [(9.52 ± 1.51),(12.01 ± 5.16)U/mg prot,F =11.627,4.824,all P ＜0.05],and the contents of LPO [(9.23 ± 2.24)μmol/g prot] was significantly higher in high-dose fluorosis group than control group [(6.09 ± 1.55)μmol/g prot,F =7.457,P ＜0.05].Conclusion JAK/STAT signaling pathway and the oxidative stress,apoptosis may be the pathogenesis of liver damage in chronic fluorosis.

Objective To investigate surgical outcomes of treatment of pilon fractures of Ruedi -Allgower types Ⅱ and Ⅲ by raft screws fixation combined with bone grafting.Methods 21 patients with pilon fractures of Ruedi -Allgower types II and Ⅲ received surgery were selected.They were 15 men and 6 women,23 to 68 years of age(average 38.2 years).16 cases were closed and 5 cases open.12 cases were type II and 9 cases type III.Intervals between injury and operation ranged from 7 to 14 days,with 8.5 days on average.All of them were treated with raft screws fixation by plate type L combined with bone grafting.Results All cases were followed up for an average of 12 months(range from 8 to 30 months).Fractures healed from 16 to 24 weeks,with 18.2 weeks on average.According to the Burwell -Charnley radiological criteria,anatomical reduction was achieved in 17 cases,and fair reduction in 4.According to the Mazur clinical criteria,ankle functions were rated as excellent in 8 cases,good in 10 cases,fair in 2 cases and poor in 1 case.The rate of excellent and good was 85.7%.Conclusion Raft screws fixation combined with bone grafting are effective for the pilon fractures of Ruedi -Allgower types II and Ⅲ,preventing articular surface collapse and leading to anatomic reduction,and has stable fixation and early functional rehabilitation.

Objective To evaluate the clinical outcome of artificial cervical disc arthroplasty combined with anchoring cervical intervertebral fusion cage (ACIFC) in the treatment of multilevel cervical disc herniation. Methods From October 2011 to September 2013, 0.26 patients with multilevel cervical disc herniation underwent artificial cervical disc arthroplasty combined with ACIFC, there were 10 male and 16 female with age from 32 to 60 years (mean 46.8 years). Two segment were involved in 15 patients, three segment were involved in 11 patients. Neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were used to evaluate neurofunctional recovery preoperatively and postoperatively. The postoperative stabilization and the range of motion (ROM) of implanted disc and the fusion of cage were observed on dynamic radiograph. Results The average operation time and amount of bleeding were (95±15) min and (100±20) ml respectively. The average postoperative follow-up was 15 months(range 6-20 months). At the end of follow up,the scores of JOA was increased and the scores of NDI was decreased:(9.08±1.72) scores vs. (14.88±1.37) scores, (40.31±4.97) scores vs. (25.23±4.10) scores,there had significant differences (P<0.05). The change of ROM had no significant difference ( P>0.05). Solid fusion was achieved in all levels brought by cage.There was no cage subsidence or displacement. All artificial cervical disc achieved definite stabilization, no intraoperative and postoperative complication was noted. Conclusions Artificial cervical disc arthroplasty combined with ACIFC provides a feasible way for the treatment of multilevel cervical disc herniation. The definite stabilization and maintained ROM can reduce the fusion segments and avoid the increased stress of adjacent segment which can ensure a good preliminary clinical outcome.